Infectious Disease Flashcards

1
Q

Vaccination schedule?

A

2 months - 6in1, PCV, MenB, rotavirus
4 months - 6in1, MenB, rotavirus
6 months - 6in1, PCV, MenC
12 months - MMR, MenB
13 months - HiB/MenC, PCV

Junior Infants - MMR and 4in1
First Year - HPV, Tdap and Men ACWY

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2
Q

What vaccines are in the 6in1?

A

diphtheria
tetanus
polio
pertussis
Hep B
haemophilus influenza B

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3
Q

What vaccines are in the MMR vaccine?

A

measles
mumps
rubella

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4
Q

What vaccines are in the 4in1 vaccine?

A

diphtheria
tetanus
polio
pertussis

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5
Q

What vaccines are in the Tdap vaccine?

A

tetanus
low dose pertussis
low dose diphtheria

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6
Q

Causes of bacterial meningitis?

A

children and adults -> NHS
neonates -> GBS, E coli, Listeria

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7
Q

Presentation of meningitis?

A

fever
neck stiffness
photophobia
headache
vomiting
reduced consciousness
seizures
neonates -> hypotonia, poor feeding, lethargy, irritability, hypothermia, bulging fontanelle

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8
Q

Special tests for meningitis?

A

Kernig’s test (lying on back with hip flexed and straighten knee- pain and resistance = positive)
Brudzinski’s test (lie on back and flex neck- knee and hip flexion = positive)

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9
Q

Mx of meningitis?

A

in community give stat dose of IM benzylpenicillin before transfer
ideally LP before antibiotics but don’t delay
<3 months -> amoxicillin + cefotaxime
>3months -> ceftriaxone
dexamethasone to reduce hearing loss and neuro damage
acyclovir to cover for viral

prophylaxis to close contacts -> stat dose of ciprofloxacin or rifampicin

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10
Q

Causes of viral meningitis?

A

herpes simplex virus
enterovirus
varicella zoster virus

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11
Q

Lumbar puncture viral vs bacterial?

A

bacterial cloudy, viral clear
protein high in bacterial, normal in viral
glucose low in bacterial, normal in viral
neutrophil-predominant in bacterial, lymphocyte-predominant in viral

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12
Q

Complications of meningitis?

A

sensorineural hearing loss
seizures and epilepsy
cognitive impairment and learning disability
memory loss
cerebral palsy

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13
Q

Most common cause of encephalitis?

A

viruses
bacterial and fungal v rare

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14
Q

Viral causes of encephalitis?

A

HSV (most common)
VZV
CMV
EBV
enterovirus
adenovirus
influenza
polio, mumps, rubella (always ask about vaccines)

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15
Q

Presentation of encephalitis?

A

altered consciousness
altered cognition
unusual behaviour
acute onset of focal neurological symptoms
acute onset of focal seizures
fever

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16
Q

Investigations for encephalitis?

A

LP
CT (if LP contraindicated)
MRI
EEG
swabs
HIV testing

17
Q

Contraindications for LP?

A

GCS<9
haemodynamically unstable
active seizures
post-ictal
meningococcal septicaemia
raised ICP

18
Q

Mx of encephalitis?

A

acyclovir (HSV, VZV)
ganciclovir (CMV)

19
Q

Complications of encephalitis?

A

prolonged recovery
fatigue
change in personality or mood
change to memory or cognition
learning disability
headache
chronic pain
movement disorders
sensory disturbance
seizures
hormonal imbalance

20
Q

What is infectious mononucleosis caused by?

A

Ebstein-Barr Virus

21
Q

Presentation of infectious mononucleosis?

A

fever
sore throat
fatigue
lymphadenopathy
tonsillar enlargement
splenomegaly (rarely splenic rupture)

rash after penicillins

22
Q

Complications of infectious mononucleosis?

A

splenic rupture
glomerulonephritis
haemolytic anaemia
thrombocytopenia
chronic fatigue
malignancy (Burkitt’s lymphoma)

23
Q

Most common complication post-meningitis?

A

sensorineural hearing loss

24
Q

Protection against mumps provided by the MMR vaccine?

A

80%

25
Q

Presentation of mumps?

A

pro-drome flu-like symptoms a few days before parotid swelling

fever
muscle aches
lethargy
reduced appetite
headache
dry mouth

parotid gland swelling
testicular pain (orchitis)
abdo pain (pancreatitis)
confusion, neck stiffness, photophobia (meningitis, encephalitis)

26
Q

Mx of mumps?

A

diagnosis confirmed by PCR of saliva
notifiable disease
supportive management

27
Q

Complications of mumps?

A

orchitis
pancreatitis
meningitis
encephalitis
sensorineural hearing loss

28
Q

Prevention of HIV transmission during birth?

A

normal vaginal delivery if viral load <50
C section considered if >50 and done in all >400
IV zidovudine if >10,000

29
Q

Prophylaxis for HIV in neonates?

A

low-risk babies where maternal viral load <50 should get zidovudine for 4wks
high-risk babies should get zidovudine, lamivudine and nevirapine for 4wks

30
Q

Breast feeding in mothers with HIV?

A

never acceptable

31
Q

Testing of children with HIV positive parents?

A

HIV viral load at 3 months
HIV antibody test at 24 months

(antibody test may be falsely positive up to 18 months due to maternal antibodies that crossed the placenta)